Health Sciences Program Student Theses, Dissertations and Capstones

Document Type

Dissertation - NSU Access Only

Degree Name

Doctor of Philosophy (PhD) in Health Science

Copyright Statement

All rights reserved. This publication is intended for use solely by faculty, students, and staff of Nova Southeastern University. No part of this publication may be reproduced, distributed, or transmitted in any form or by any means, now known or later developed, including but not limited to photocopying, recording, or other electronic or mechanical methods, without the prior written permission of the author or the publisher.

Department

College of Health Care Sciences – Health Science Department

First Advisor

Sarah Ransdell

Date of original Performance / Presentation

January 2023

Publication Date / Copyright Date

1-1-2023

Abstract

Shared Decision Making (SDM) is the process by which patients and clinicians work together to identify the best treatment plan for a specific condition. Through deliberation and consideration of any alternative options, patients and clinicians come together to determine the best course of action through consensus and agreement. The choice of which ear to implant initially in adult bilateral cochlear implant (CI) candidates can sometimes require deliberation between the patient, audiologist, and surgeon. Each party may have their own reason for recommending one ear over the other for implantation. The patient may prefer to implant their worse hearing ear or the ear that performs worse with hearing aids. The audiologist may prefer to implant the ear that has the best potential for speech understanding post implant. The surgeon may prefer to implant the ear that has the worse balance function or that has no anatomical contraindications to surgery. This dissertation has two primary purposes. First, the investigator sought to understand how pre-implant vestibular and radiographic studies influenced the CI surgery ear decision in adult bilateral candidates. These pre-implant tests were statistically significant predictors of the CI surgery ear. Second, the investigator sought to understand how a hypothetical construct agreement between the patient, audiologist, and surgeon on the CI surgery ear influences post implant outcomes of speech understanding and dizziness or imbalance. The results showed that agreement through successful SDM was a significant predictor of improved speech understanding but not of dizziness/imbalance post implant.

Disciplines

Medicine and Health Sciences

Keywords

cochlear implants; shared decision-making; vestibular

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